"The fourth-century Christian theologian Augustine characterized the sexual act between spouses as immoral self-indulgence if the couple tried to prevent conception. The church, however, had little to say about contraception for many centuries. For example, after the decline of the Roman Empire, the church did little to explicitly prohibit contraception, teach against it, or stop it, though people undoubtedly practiced it. Most penitence manuals from the Middle Ages, which directed priests what types of sins to ask parishioners about, did not even mention contraception. It was only in 1588 that Pope Sixtus V took the strongest conservative stance against contraception in Catholic history. With his papal bull “Effraenatam,” he ordered all church and civil penalties for homicide to be brought against those who practiced contraception. However, both church and civil authorities refused to enforce his orders, and laypeople virtually ignored them. In fact, three years after Sixtus’s death, the next pope repealed most of the sanctions and told Christians to treat “Effraenatam” “as if it had never been issued.” By the mid-17th century, some church leaders even admitted couples might have legitimate reasons to limit family size to better provide for the children they already had."